Therapy

Doc Payment Fix in the Works?

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Here’s an oldie but a goodie for today. The House Ways and Means Committee is reportedly considering a markup of legislation this month that would revamp Medicare’s physician payment system. This move could increase the likelihood of incorporating a “doc fix” into a lame duck legislative package. Historic readers and followers of Reg’s Blog will … Read more

Post-Acute, Site Neutral Payment Upcoming?

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In the 2019 OPPS (outpatient PPS) proposed rule, CMS included a site neutral payment provision.  With the comment period closed, the lobbying (against) fierce, it will be interesting to see where CMS lands in terms of the final OPPS rule – maintain, change, or abate.  The one thing that is for certain, regardless of the … Read more

RehabCare, Therapy Fraud and Lessons Not Quite Learned

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This last week the Department of Justice and CMS announced a $125 million settlement with RehabCare, a subsidiary of Kindred Healthcare, regarding improper Medicare billing.  As in virtually all cases of a similar nature involving false or improper billing to the Medicare program, this matter began with a whistleblower suit (insiders establishing False Claims Act violations … Read more

Core Administrative Competency: SNF

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As I have written before and readers know, I field as many questions and provide as many resources as I can “free” of charge.  My e-mail is publicly available for contact on this site and on my LinkedIn page.  The title of this post thus, is a reference to the many questions I’ve received as of … Read more

SNFs, Therapy Contracts and Fraud: Redux

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Yes another SNF, another therapy contract and more fraud settlements.  The only thing that isn’t different is the contractor – RehabCare once again (a coincidence?…not likely). In news released late last week, a Maine SNF settled with the Department of Justice for $1.2 million, allegations of improper Medicare billings for “unnecessary, inflated, and unreasonable” therapy … Read more

SNFs, Therapy Contracts and Fraud: Another Warning and Example

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I know I sound redundant but clearly, the message is still not permeating through the industry (except for readers here). The Department of Justice and the OIG for the Department of Health are scrutinizing SNFs, their therapy billings, and the use of therapy contractors.  Why?  It is all due to a known and now routinely … Read more

SNFs, Therapy Companies, and Billing Risk

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Readers, followers (Twitter, etc.) and folks who have attended one or more of my industry conference presentations know that I routinely harp on the “risk/reward” relationship between SNFs and therapy companies (the contract therapy provides).  Last year at LeadingAge’s annual conference in Dallas, the principals from Theracore Management Group and me did a full session … Read more

SNF Outlook: 2013

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As luck would have it, work interfered with my plans to have all of the industry outlooks for this year complete and published by February 1.  Good news: Ground work is done now I just need to get to the writing and editing on a consistent basis.  With any luck and a bit of fortitude, … Read more

Medicare Outpatient Therapy Rates: Part B

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I have a schedule or table if you prefer, of 2013 Part B Therapy Rates applicable to common SNF codes.  It is applicable as user selects, for the entire U.S.  As rates are only available on a “guesstimated” basis right now and somewhat subject to slight modifications, the version is not 100% guaranteed.  I do … Read more

Health Policy News: Too Good to be Quieted by Election Coverage

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With all of the election news blaring (thank goodness the end is soon here), some important health policy issues have been somewhat lost in the milieu.  Below is a quick summary of what has caught my attention as of late (a heads-up for readers). Medicare/SNF Class Action Settlement: This is profound on a number of … Read more